Michigan Laws 550.1504 – Reimbursement arrangements; goals; definitions; supplemental efforts
Current as of: 2023 | Check for updates
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Terms Used In Michigan Laws 550.1504
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories belonging to the United States; and the words "United States" shall be construed to include the district and territories. See Michigan Laws 8.3o
- United States: shall be construed to include the district and territories. See Michigan Laws 8.3o
(1) A health care corporation shall, with respect to providers, contract with or enter into a reimbursement arrangement to assure subscribers reasonable access to, and reasonable cost and quality of, health care services, in accordance with the following goals:
(a) There will be an appropriate number of providers throughout this state to assure the availability of certificate-covered health care services to each subscriber.
(b) Providers will meet and abide by reasonable standards of health care quality.
(c) Providers will be subject to reimbursement arrangements that will assure a rate of change in the total corporation payment per member to each provider class that is not higher than the compound rate of inflation and real economic growth.
(2) As used in this section:
(a) “Gross national product in constant dollars” means that term as defined and annually published by the United States department of commerce, bureau of economic analysis.
(b) “Implicit price deflator for gross national product” means that term as defined and annually published by the United States department of commerce, bureau of economic analysis.
(c) “Inflation” or “I” means the arithmetic average of the percentage changes in the implicit price deflator for gross national product over the 2 calendar years immediately preceding the year in which the commissioner’s determination is being made.
(d) “Compound rate of inflation and real economic growth” means the ratio of the quantity “100 plus inflation”, multiplied by the quantity “100 plus real economic growth”, to 100; minus 100; or as expressed in the following formula:
| ( | (100 + I) x (100 + REG) | ) |
| ( | 100 | ) -100 |
| ( | ) |
(e) “Rate of change in the total corporation payment per member to each provider class” means the arithmetic average of the percentage changes in the corporation payment per member for that provider class over the 2 years immediately preceding the commissioner’s determination.
(f) “Real economic growth” or “REG” means the arithmetic average of the percentage changes in the per capita gross national product in constant dollars over the 4 calendar years immediately preceding the year in which the commissioner’s determination is being made.
(3) Nothing in this section shall preclude efforts by a health care corporation supplemental to the goals prescribed in subsection (1).